Monthly Archives: May 2013

Government and Doctors Where Does Responsibility Lie with Healthcare

Government and Doctors What’s The Feds Role?

government and doctorsWe’ve all seen changes in healthcare as spring moves to summer 2013.  While many changes aren’t due year, there have been some pretty significant shifts to the healthcare system, particularly in Medicare.  Shifts like the Hospital readmission fines and planned cuts to Medicare hospital reimbursement plus the 2% sequestration cuts for physicians and hospitals have been enacted with the hopes that it will lower costs and improve the healthcare system as a whole. But looking at it from a different angle, you can pose the question, “Is government doing enough for doctors in healthcare reform?”  The healthcare system only works if it works both ways; for Patients and for Doctors.  If the reform raises costs or reduces reimbursements to the point where many Doctors can’t pay off medical school bills, it may be a deterrent that will lower physician availability in the future.

What Government Must Do For Doctors

We all agree reform needs to be enacted but can we really afford to do so if it threatens physician availability?   The question is, is it the responsibility of the government to recognize this aspect of the healthcare industry.  The relationship between government and doctors has always been love-hate.  There are arguments supporting both sides of these complex arguments but one thing is for sure, a lack of doctors and therefore accessibility for all Patients is a risk that needs to be considered.  Both the patient and doctor are equally important and the government must find a way to make the system work for both.

Hospital Readmission Penalties Questioning The Legislation

Hospital Readmission Penalties: Are they Fair


Property of

If you were in denial before you can’t be anymore.  Obamacare and the roll out of new healthcare overhauls associated with it are starting to take effect.  One of the more controversial elements of healthcare reform is the new Hospital Readmission Penalties which took effect in October of last year.  Hospitals are being hit with additional new costs when Patients have to readmit to the hospital for the same ailment they initially went in with.  So is this fair?  Lets look at the rationale for the legislation as well as the argument against enforcement.

Supporters of the legislation believe that the effort will begin to reduce “costly and unnecessary readmissions”, and there are now statistics supporting that theory.  According to the latest studies, medicare costs are beginning to shift in a downward direction.  But is the slow decline in Medicare cost worth the hefty fines hospitals could pay for readmitting patients?  Opponents say the regulation is a tax targeted at hospitals that tend to take care of the sickest patients, and those in certain socioeconomic demographics.  This isn’t so much a numbers debate as it is a moral one.  Who is right and who is wrong?

Government Protection vs. Personal Respobsibility

The moral quandary that faces legislators and regulators when dealing with the issues of hospital penalties is how much responsibility falls on the shoulders of the healthcare provider, and how much on the individual patient.  In order to avoid these fines, many hospitals have gone well beyond their healthcare responsibilities.  For example: providing transportation for follow-up visits, getting safe housing for patients or even just a hot meal to ensure they stay healthy.  But once they leave the Hospital, can a patient really still be the hospital’s responsibility?  Opponents of the regulation feel it’s a lose/lose situation and that no matter what, hospitals are incurring more cost.  Medicare has reported that it expects an additional $300 million dollars in revenues from these fines in 2013 alone.

It is clearly the responsibility of a hospital to try and bring each patient back to health, no question about it.  But where does the responsibility end?  Different individuals, hospitals and regulators will have differing answers. But eventually the answer may have a big impact on our healthcare system.

For the latest in medical billing news and legislation click HERE today.